Strictly speaking, infective endocarditis (IE) is a disease in which an infective organism colonizes the heart valves, septal defects or mural endocardium. The clinical syndrome of IE consists of fever, changing murmurs, septic embolization to any organ and petechial lesions of the skin. IE is largely a clinical diagnosis, based on history and clinical examination, that is confirmed with blood cultures and echocardiography. The choice and duration of antimicrobial therapy for patients with IE should eventually be dictated by the pathogens identified from blood cultures. IE is a life-threatening disease and carries a high risk of morbidity and mortality despite modern antimicrobial and surgical treatment. Anticoagulant therapy has not been shown to prevent embolization in IE and may increase the risk of intracerebral haemorrhage. Most patients with IE respond to appropriate antibiotic treatment within 72 hours, with a reduction in fever and improvement in general well-being.